关键词: 原发性肝癌；肝切除术；肌少症；尿酸

Abstract: Objective To explore the predictive value of serum uric acid levels for the occurrence of sarcopenia after hepatectomy in patients with primary liver cancer (PLC).Method A convenience sampling method was used to prospectively include 161 PLC patients who underwent liver resection surgery at Baoding NO.2 Central Hospital of Hebei Province from January 2019 to December 2021.They were divided into occurrence group and non occurrence group based on whether they had muscle deficiency.The clinical data,serum uric acid and other blood biochemical examination results were compared between the two groups,and the predictive value and influence of serum uric acid level on sarcopenia after hepatectomy in PLC patients were analyzed.Results Among the 158 PLC patients who underwent hepatectomy in the final inclusion of this study,34 patients developed postoperative sarcopenia,with an incidence rate of approximately 21.52%.The serum uric acid level (311.79±35.32) μmol/L in the occurrence group was higher than that in the non-occurrence group (280.52±31.15) μmol/L,the ALB level (31.59±5.73) g/L was lower than that in the non-occurrence group (35.63±5.13) g/L,and the proportion of postoperative adjuvant hepatic arterial infusion chemotherapy (HAIC) (38.24%) was higher than that in the non-occurrence group (20.16%),with statistical significant differences (P＜0.05).Multiple Logistic regression analysis showed that serum uric acid 、 ALB 、postoperative adjuvant HAIC were associated with sarcopenia after hepatectomy in PLC patients(OR=0.853,1.035,11.189,95%CI:0.770-0.945，1.018-1.052，3.533-35.433,P＜0.05).The receiver operating characteristic curve (ROC) showed that the area under the curve (AUC) of serum uric acid in predicting sarcopenia after hepatectomy in PLC patients was 0.754(95%CI:0.657-0.850),which had certain predictive value.The nomogram showed that the C-index of the prediction model constructed by serum uric acid assisted other major clinical indicators to predict the occurrence of sarcopenia after hepatectomy in PLC patients was 0.847(95%CI:0.782-0.913),suggesting that the model had certain predictive value.The results of the decision curve showed that when the threshold was in the range of 0.00-1.00,the actual clinical net benefit rate of the model was always greater than 0,and the maximum net benefit rate was 0.215,suggesting that the model had good clinical application value.Conclusion The increase of serum uric acid level in PLC patients is a risk factor for postoperative sarcopenia.The detection of serum uric acid level is helpful to assist in the early prediction of the risk of sarcopenia.

Key words: primary liver cancer；hepatectomy；sarcopenia；uric acid